Provider Demographics
NPI:1487885604
Name:LG PHARMACIES, LLC
Entity type:Organization
Organization Name:LG PHARMACIES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/LLC MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:URIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-842-8790
Mailing Address - Street 1:1620 HIGH ST
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-4536
Mailing Address - Country:US
Mailing Address - Phone:650-842-8790
Mailing Address - Fax:510-842-8789
Practice Address - Street 1:1620 HIGH ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-4536
Practice Address - Country:US
Practice Address - Phone:650-842-8790
Practice Address - Fax:510-842-8789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA500303336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy